Living Trust Consultation Form Δ Status* Married* Single First Name*Last Name*Date of Birth* U.S. Citizen* Yes No Spouse/Partner’s First NameSpouse/Partner’s Last NameDate of Birth U.S. Citizen* Yes No Physical address line 1Physical address line 2City*State* State *AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Code*Phone 1 numberOffice Phone:Cell NumberEmail Address* Spouse’s Email Address How many children do you have?How many children do you have ?012345678Your Child's Full NameSexDate of Birth Please select who is the parent Both Partner 1 Partner 2 Married Yes No Does this child have their own children? Yes No Children’s Full NamesSexDate of Birth Please select who is the parent Both Partner 1 Partner 2 Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Please select who is the parent Both Partner 1 Partner 2 Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Please select who is the parent Both Partner 1 Partner 2 Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Please select who is the parent Both Partner 1 Partner 2 Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Please select who is the parent Both Partner 1 Partner 2 Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Please select who is the parent Both Partner 1 Partner 2 Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Please select who is the parent Both Partner 1 Partner 2 Married Yes No Does this child have their own children? Yes No This field is hidden when viewing the formhow many childHow many children do you have?012345678Your Child's Full NameSexDate of Birth Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Married Yes No Does this child have their own children? Yes No Your Child's Full NameSexDate of Birth Married Yes No Does this child have their own children? Yes No Number of Parcels of California Real EstateNumber of Parcels of Real Estate Outside of CaliforniaDoes either spouse hold any sole and separate (versus community) property? ** Yes No Approximate gross value of my entire estate*Financial Decision Makers*We recommend that each person identify three (3) people and/or an institution to act on their behalf regarding financial matters in the event of incapacity or upon death. Yes, I have three people and/or an institution to provide to the attorney during my consultation. No, I do not currently have three people and/or an institution identified and will consider this further prior to my consultation. No, I do not currently have three people and/or an institution identified and would like to discuss this during my consultation. Medical Decision Makers*We recommend that each person identify three (3) people to make medical decisions on their behalf in the event of incapacity. Yes, I have three people to provide to the attorney during my consultation. No, I do not currently have three people identified and will consider this further prior to my consultation. No, I do not currently have three people identified and would like to discuss this during my consultation. Please check one of the following boxes:* I am ready to proceed with the creation of my plan. I am not interested in creating a plan at this time. I’m here for general information only. I need the following questions answered before I am ready to proceed with the creation of my plan: Questions Do you have an existing Will?* Yes No Do you have an existing Living Trust?* Yes No Were you referred to our office? If so, please let us know who referred you so we may thank them.